U.S. patent application number 13/949032 was filed with the patent office on 2014-01-23 for glenoid implants having adjustable base plates.
The applicant listed for this patent is TORNIER ORTHOPEDICS IRELAND LTD.. Invention is credited to Wayne BURKHEAD, Jean-Emmanuel CARDON, John FENLIN, Gregory P. NICHOLSON.
Application Number | 20140025173 13/949032 |
Document ID | / |
Family ID | 47295005 |
Filed Date | 2014-01-23 |
United States Patent
Application |
20140025173 |
Kind Code |
A1 |
CARDON; Jean-Emmanuel ; et
al. |
January 23, 2014 |
GLENOID IMPLANTS HAVING ADJUSTABLE BASE PLATES
Abstract
A glenoid implant for a shoulder prosthesis is adapted to be
implanted in the glenoid of a patient. The glenoid implant includes
an articular body for articulating the glenoidal implant with a
humeral component. A plate supports the articular body. An
anchoring mechanism for anchoring the glenoid implant along an
anchoring axis is adapted to be secured to the glenoid. A securing
mechanism secures the plate in position relative to the anchoring
mechanism and the glenoid. An adjustment mechanism facilitates
selectively adjusting the position of the plate, before it is
secured in position by the securing mechanism, in rotation about
the anchoring axis and in translation transversely relative to the
anchoring axis.
Inventors: |
CARDON; Jean-Emmanuel;
(Biviers, FR) ; FENLIN; John; (Bryn Mawr, PA)
; NICHOLSON; Gregory P.; (Western Springs, IL) ;
BURKHEAD; Wayne; (Dallas, TX) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
TORNIER ORTHOPEDICS IRELAND LTD. |
Macroom |
|
IE |
|
|
Family ID: |
47295005 |
Appl. No.: |
13/949032 |
Filed: |
July 23, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61674702 |
Jul 23, 2012 |
|
|
|
Current U.S.
Class: |
623/19.13 |
Current CPC
Class: |
A61B 17/86 20130101;
A61F 2002/30878 20130101; A61F 2002/4085 20130101; A61F 2002/30553
20130101; A61F 2002/30332 20130101; A61F 2002/30507 20130101; A61F
2002/30777 20130101; A61F 2/4081 20130101; A61F 2002/3054
20130101 |
Class at
Publication: |
623/19.13 |
International
Class: |
A61F 2/40 20060101
A61F002/40 |
Foreign Application Data
Date |
Code |
Application Number |
Sep 18, 2012 |
FR |
1258748 |
Claims
1. A glenoid implant for a shoulder prosthesis, the glenoid implant
being adapted to be implanted in the glenoid of a patient and
comprising: an articular body for articulating the glenoid implant
with a humeral component; a plate for supporting the articular
body; an anchoring mechanism for anchoring the glenoid implant
along an anchoring axis and adapted to be secured to the glenoid;
and a securing mechanism for securing the plate in position
relative to the anchoring mechanism and the glenoid; an adjustment
mechanism for selectively adjusting the position of the plate,
before it is secured in position by the securing mechanism, in
rotation about the anchoring axis and in translation transversely
to the anchoring axis.
2. The glenoid implant according to claim 1, wherein the adjustment
mechanism includes a ball-type connection for selectively tiltably
adjusting the position of the plate, before it is secured in
position by the securing mechanism, relative to the anchoring
axis.
3. The glenoid implant according to claim 1, wherein the adjustment
mechanism includes a groove formed in the plate, the groove
extending in a direction transverse to the anchoring axis and
facilitating adjustment of the position of the plate transversely
to the anchoring axis and independently of rotation of the plate
about the anchoring axis.
4. The glenoid implant according to claim 3, wherein the groove
includes at least two cavities that each define a distinct position
of the plate transverse to the anchoring axis and independently of
rotation of the plate about the anchoring axis.
5. The glenoid implant according to claim 1, wherein the adjustment
mechanism includes a pin that cooperates with the anchoring
mechanism and the plate to adjust the position of the plate
relative to the anchoring axis.
6. The glenoid implant according to claim 1, wherein the articular
body has one of an anatomic and a reversed configuration.
7. A glenoid implant for a shoulder prosthesis, the glenoid implant
being adapted to be implanted in the glenoid of a patient and
comprising: an anchor adapted to be secured to the glenoid, the
anchor defining an anchoring axis; a base including a slot adapted
to relatively movably receive the anchor, the slot and the anchor
facilitating rotational adjustment of the base relative to the
anchor about the anchoring axis and translational adjustment of the
base relative to the anchor in a direction transverse to the
anchoring axis; and an articular body adapted to be supported by
the base and to articulate with a humeral component.
8. The glenoid implant according to claim 7, wherein the base
further includes a hole, and further comprising a screw adapted to
be received by the hole and secured to the glenoid to inhibit
rotational and translational adjustment of the base relative to the
anchor.
9. The glenoid implant according to claim 8, wherein the screw is a
multidirectional screw.
10. The glenoid implant according to claim 7, wherein the slot
includes a plurality of cavities adapted to receive the anchor,
each of the cavities defining an eccentric axis about which the
base is rotatably adjustable relative to the anchor.
11. The glenoid implant according to claim 7, wherein the anchor
includes: an insert adapted to be secured to the glenoid; and an
adjustment pin adapted to be detachably coupled to the insert, the
adjustment pin being adapted to be relatively movably received by
the slot, the slot and the adjustment pin facilitating rotational
adjustment of the base relative to the anchor about the anchoring
axis and translational adjustment of the base relative to the
anchor in the direction transverse to the anchoring axis.
12. The glenoid implant according to claim 11, wherein the anchor
further includes a screw adapted to engage the insert and be
secured to the glenoid.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application claims the benefit of U.S. Provisional
Patent Application Ser. No. 61/674,702, filed on Jul. 23, 2012, and
French Patent Application No. 1258748, filed on Sep. 18, 2012,
which are hereby incorporated by reference in their entirety.
TECHNICAL FIELD
[0002] The present invention relates to glenoid implants for
shoulder prostheses. The invention also relates to support plates
for articular bodies suitable for being provided in such glenoid
implants. The invention also relates to surgical kits including
such glenoid implants.
BACKGROUND
[0003] A glenoid implant typically includes an articular body that
is adapted to articulate with the head of a humeral component (for
example, the anatomical head of the humerus or a portion of a
humeral implant). In some cases, the glenoid implant may provide an
anatomical configuration in which the articular body includes a
cavity which replaces the glenoid cavity. In other cases, the
glenoid implant may provide a reversed configuration in which the
articular body includes a hemispherical dome that cooperates with a
complementary cavity defined by a humeral implant. The articular
body may include metal, for example, a titanium alloy, ceramic
material, or a synthetic material, for example, polyethylene.
[0004] For some designs, an implant includes an insert for fixing
the articular body to the glenoid. The insert is permanently
secured in the glenoid by the surgeon before the articular body is
positioned on the insert. The implant also includes means for
securing the rotation of the insert and the articular body in
relation to the glenoid. In some cases, the glenoid implant needs
to be replaced. The insert remains coupled to the glenoid and the
articular body is replaced. The surgeon may provide, with relative
difficulty, a new articular body of a different configuration. For
example, the implant may be converted from an anatomical
configuration to a reversed configuration. Furthermore, if the
implant is to be converted from an anatomical configuration to a
reversed configuration, the glenoid dome must typically be offset
toward an inferior portion of the glenoid relative to the position
previously defined by the insert. In other words, the articular
center for a glenoid component having an anatomical configuration
may be different from the articular center for a glenoid component
having a reversed configuration. As such, ranges of articular
bodies are available which have different offsets of the articular
surface. However, the articular bodies are expensive and therefore
this solution is not completely satisfactory.
SUMMARY
[0005] In some embodiments, an object of the present invention is
to provide an improved glenoid implant, particularly in terms of
versatility, simplicity, and cost of implementation.
[0006] In some embodiments, the invention relates to a glenoid
implant for a shoulder prosthesis. The glenoid implant is adapted
to be implanted in the glenoid of a patient. The glenoid component
includes an articular body for articulating the glenoid implant
with a humeral component. A plate supports the articular body. An
anchoring mechanism anchors the glenoid component along an
anchoring axis and is adapted to be secured to the glenoid. A
securing mechanism secures the plate in position relative to the
anchoring mechanism and the glenoid. An adjustment mechanism
facilitates selectively adjusting the position of the plate, before
it is locked in position by the securing mechanism, in rotation
about the anchoring axis and in translation transversely relative
to the anchoring axis.
[0007] In some embodiments, the invention improves the versatility,
the simplicity, and the cost of implementing a glenoid implant,
which may have an anatomical or reversed configuration. In some
embodiments, the anchoring mechanism may remain implanted in the
glenoid to facilitate later revision of the shoulder prosthesis. In
some embodiments, the adjustment mechanism facilitates accurate
positioning of the plate and, thus, the articular body relative to
the anchoring mechanism and the glenoid. In some embodiments, the
offset of the articular body relative to the anchoring mechanism,
and thus the glenoid, is adjusted via the plate and the adjustment
mechanism; as such, a variety of potentially expensive articular
bodies are not needed. In some embodiments, the plate may be
rotatably and transversely translatably adjusted to occupy a
desired position based on the anatomical dimensions of the shoulder
of the patient. In some embodiments, the plate may be pivotably or
tiltably adjusted relative to the anchoring axis if the surface of
the glenoid is not perpendicular to the anchoring axis. In some
embodiments, implants according to the invention are modular and
convertible. In some embodiments, implants according to the
invention are provided as part of a surgical kit.
[0008] In some embodiments, the adjustment mechanism includes a
ball-type connection that is adapted to facilitate adjusting the
position of the plate, before it is locked in position by the
securing mechanism, tiltably relative to the anchoring axis. In
some embodiments, the adjustment mechanism includes a groove formed
in the plate. The groove extends in a direction transverse to the
anchoring axis and facilitates adjustment of the position of the
plate transversely to the anchoring axis and independently of
rotation of the plate about the anchoring axis. In some
embodiments, the groove includes at least two cavities that each
define a distinct position of the plate transverse to the anchoring
axis and independently of rotation of the plate about the anchoring
axis. In some embodiments, the adjustment mechanism includes a pin
that cooperates with the anchoring mechanism and the plate to
adjust the position of the plate relative to the anchoring axis. In
some embodiments, the articular body has one of an anatomic and a
reversed configuration.
[0009] In some embodiments, the invention provides a plate for
supporting an articular body. Such a plate is part of a glenoid
implant as described above.
[0010] In some embodiments, the invention relates to a glenoid
implant for a shoulder prosthesis. The glenoid implant is adapted
to be implanted in the glenoid of a patient. The glenoid implant
includes an anchor adapted to be secured to the glenoid. The anchor
defines an anchoring axis. A base includes a slot adapted to
relatively movably receive the anchor. The slot and the anchor
facilitate rotational adjustment of the base relative to the anchor
about the anchoring axis and translational adjustment of the base
relative to the anchor in a direction transverse to the anchoring
axis. An articular body is adapted to be supported by the base and
to articulate with a humeral component.
[0011] In some embodiments, the invention provides a surgical kit
that includes one or more glenoid implants for a shoulder
prosthesis (for example, including a glenoid implant as described
above). The glenoid implant is adapted to be implanted in the
glenoid of a patient. The kit includes at least one articular body
for articulation of the glenoid implant with a humeral component.
The kit further includes at least one plate for supporting the
articular body. The kit includes an anchoring mechanism that
defines an anchoring axis and is adapted to be secured to the
glenoid. The kit includes a securing mechanism for securing the
position of the plate relative to the anchoring mechanism and the
glenoid. The kit further includes an adjustment mechanism for
selectively adjusting the position of the at least one plate,
before it is locked in position by the securing mechanism, in
rotation about the anchoring axis and transversely relative to the
anchoring axis.
[0012] In some embodiments, the adjustment mechanism includes a
groove formed in the at least one of the plate along a direction
transverse to the anchoring axis. The groove facilitates adjusting
the position of the plate transversely relative to the anchoring
axis independently of rotation of the plate about the anchoring
axis. In some embodiments, the kit includes at least two
selectively adjustable plates. The plates are selectively
adjustable to different configurations in terms of rotation about
the anchoring axis and transversely relative to the anchoring
axis.
[0013] While multiple embodiments are disclosed, still other
embodiments of the present invention will become apparent to those
skilled in the art from the following detailed description, which
shows and describes illustrative embodiments of the invention.
Accordingly, the drawings and detailed description are to be
regarded as illustrative in nature and not restrictive.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] FIG. 1 is an exploded perspective view of a glenoid implant
and a plate of the glenoid implant according to embodiments of the
present invention;
[0015] FIG. 2 is another exploded perspective view of the glenoid
implant and the plate of FIG. 1;
[0016] FIG. 3 is a partial section view of the glenoid implant of
FIG. 1 implanted in the glenoid of a patient;
[0017] FIG. 4 is a front elevation view of the plate of FIG. 1;
[0018] FIG. 5 is a side view of a pin of the glenoid implant of
FIG. 1;
[0019] FIG. 6 is a partial perspective view of the glenoid implant
of FIG. 1 in an assembled configuration;
[0020] FIG. 7 is a view of the glenoid implant along the arrow VII
in FIG. 6;
[0021] FIG. 8 is a front elevation view of a glenoid implant plate
according to embodiments of the present invention;
[0022] FIG. 9 is a front elevation view of a glenoid implant plate
according to embodiments of the present invention;
[0023] FIG. 10 is a front elevation view of a glenoid implant plate
according to embodiments of the present invention;
[0024] FIG. 11 is a front elevation view of a glenoid implant plate
suitable for equipping a surgical kit according to embodiments of
the present invention;
[0025] FIG. 12 is a perspective view of the plate of FIG. 11;
[0026] FIG. 13 is a front elevation view of a glenoid implant plate
suitable for equipping a surgical kit according to embodiments of
the present invention; and
[0027] FIG. 14 is a perspective view of the plate of FIG. 13.
[0028] While the invention is amenable to various modifications and
alternative forms, specific embodiments have been shown by way of
example in the drawings and are described in detail below. The
intention, however, is not to limit the invention to the particular
embodiments described. On the contrary, the invention is intended
to cover all modifications, equivalents, and alternatives falling
within the scope of the invention as defined by the appended
claims.
DETAILED DESCRIPTION
[0029] This application incorporates by reference U.S. patent
application Ser. No. 13/363,159, filed on Jan. 31, 2012, U.S.
Provisional Patent Application No. 61/1,438,570, filed on Feb. 1,
2011, and French Patent Application No. 20110050994, filed on Feb.
8, 2011, for all purposes.
[0030] FIGS. 1-7 illustrate a glenoid implant 1 that is adapted to
be implanted in the glenoid B of the scapula of a patient (the
glenoid B is shown only in FIG. 3, and the humerus is not
illustrated for the sake of simplification). The glenoid B includes
a bone preparation which replaces the original glenoid cavity. The
bone preparation includes an abutment surface B1 and an anchoring
cavity B2. The surface B1 is substantially planar and may be
formed, for example, by milling. The cavity B2 opens from the
glenoid B and may be at least partially surrounded by the abutment
surface B1.
[0031] Herein, in order to provide a spatial reference system, the
term "rear side" of the implant 1 refers to the elements that face
towards the glenoid B and "front side" of the implant 1 refers to
the elements that face away from the glenoid B when the implant 1
is implanted in the glenoid B. In anatomical terms, therefore, the
rear side is orientated in the medial direction and the front side
is orientated in the lateral direction of the body of the
patient.
[0032] The implant 1 includes an articular body 10 that is adapted
to articulate with a humeral component (for example, the anatomical
head of the humerus or a portion of a humeral implant). The implant
1 also includes a plate 20 (also referred to as a "base" or "base
plate") for supporting the articular body 10, which facilitates
precisely positioning the articular body 10 relative to the glenoid
B. The implant 1 also includes an adjustment pin 40, an anchoring
mechanism 50 (also referred to as an "anchor") including an insert
60 and a screw 70, and a securing screw 80. The insert 60 and the
screw 70 are adapted to be permanently fixed to the glenoid B and,
more specifically, fixed in the anchoring cavity B2 and extending
along an anchoring axis X50. The pin 40 and the screw 80 form a
securing mechanism that facilitates securing the plate 20 in
position relative to the anchoring mechanism 50 and the glenoid B.
The plate 20 includes a groove 30 (also referred to as a "slot")
for receiving the pin 40. The groove 30 and the pin 40 form an
adjustment mechanism that facilitates adjusting the position of the
plate 20 before it is selectively secured (both rotatably about the
anchoring axis X50 and translatably relative to the anchoring axis
X50) by the securing mechanism (that is, in some embodiments, the
adjustment pin 40 and the securing screw 80). In some embodiments,
the position of the plate 20 is selectively adjustable to permit
the articular body 10 to be located at a desired position relative
to the glenoid (for example, a relatively superior position or a
relatively inferior position).
[0033] The elements 10, 20, 40, 60, 70 and 80 of the implant 1 may
include one or more metals, metal alloys, ceramic materials or
biocompatible polymers. The elements 10, 20, 40, 60, 70, and 80 may
include, for example, stainless steel, titanium or titanium alloy,
cobalt/chromium alloy, pyrocarbon, PEEK or any other suitable
materials. Furthermore, the elements 10, 20, 40, 60, 70, and 80 may
be subjected to any suitable local or non-local processing or
covering operations.
[0034] In the example of the figures, the implant 1 has a reversed
configuration. As such, the articular body 10 is in the form of a
hemispherical dome. The body 10 includes an outer articular surface
11 that has a convex spherical shape and an opening at the top 12.
The body 10 also includes an internal cavity 13. In some
embodiments, the internal cavity 13 includes a frustoconical
surface 14 (see FIG. 2) for fixing to the plate 20. In some
embodiments, the surface 14 may have a cylindrical profile. The
opening 12 connects the external surface 11 and the internal cavity
13. The opening 12 permits the surgeon to access the pin 40 and the
screw 80 when the body 10 is secured to the plate 20.
[0035] The plate 20 includes an outer frustoconical surface 21 that
connects a rear side 22 and a front side 23 of the plate 20. The
outer surface 21 has a greater diameter at the rear side 22 than at
the front side 23. That is, the outer surface 21 tapers radially
outwardly proceeding from the front side 23 to the rear side 22.
The outer surface 21 engages the surface 14 of the articular body
10 in order to secure the articular body 10 relative to the glenoid
B. At the front side 23, the plate 20 includes a front edge 24
which defines a front recess 25. The plate 20 includes an opening
27 that extends through the plate 20 from the front side 23 to the
rear side 22. The opening 27 also receives the screw 80. The plate
20 includes holes 28 which are distributed on the rear side 22 to
form an irregular surface on the rear side 22 and thereby promote
bone regrowth. Besides the holes 28, the plate 20 has, at the rear
side 22, a substantially planar surface suitable for abutting
against the abutment surface B1 of the glenoid B.
[0036] The groove 30 formed in the plate 20 generally extends along
a groove axis A30, which is substantially perpendicular to the axis
X50 when the plate 20 is secured to the glenoid B. The groove 30
opens at the outer surface 21, at the rear side 22, and at the
front side 23 of the plate 20. The groove 30 includes cavities 31,
32 and 33 (see FIG. 4) which define separate positions for
rotatably adjusting the plate 20. That is, the cavities 31-33
define different eccentric positions or eccentric axes about which
the plate 20 may be selectively rotatably adjusted.
[0037] An edge 34 is formed around the cavities 31-33 at the front
side 23 of the plate 20. As such, the cavities 31-33 are relatively
narrow at the rear side 22 and relatively wide at the front side 23
of the groove 30. The edge 34 extends as a circular arc around the
center of each cavity 31-33 and has, at the front side 23, a
concavity that receives the pin 40. The cavity 31 is nearer to the
center of the plate 20 and the recess 25 relative to the outer
surface 21. The cavity 33 is formed near the outer surface 21 and
the edge 24. The cavity 32 is formed between the cavities 31 and 33
in the recess 25. Along the axis A30, the groove 30 terminates at
the end of the cavity 31 and includes a transverse opening 35
defined near the cavity 33 and the outer surface 21.
[0038] The pin 40 facilitates adjustment of the position of the
plate 20 relative to the anchoring mechanism 50. The pin 40
includes a cylindrical rod 41 that connects a head 42 to a threaded
base 46. The head 42 includes a curved rear surface 43 and an
opening or hole 44, which may have a hexagonal shape, for receiving
a tool (not shown), such as a surgical screwdriver. The rod 41
extends between the curved rear surface 43 of the head 42 and a
front annular planar surface 47 of the base 46. The base 46 further
includes a threaded surface 48 and a rear planar surface 49. The
threaded base 46 may be coupled to (that is, screwed into) the
anchoring mechanism 50 by inserting a tool, such as a surgical
screwdriver, into the hole 44 and rotating to the tool to rotate
the pin 40 about the anchoring axis X50. The head 42 of the pin 40
may be received in one of any of the cavities 31-33 to secure the
plate 20 relative to the glenoid B in a position defined by the
cavity 31, 32, or 33. As such and as described in further detail
below, the pin 40 defines, in part, both to the adjustment
mechanism and the securing mechanism.
[0039] The anchoring mechanism 50 is defined by the insert 60 and
the screw 70 and extends along the anchoring axis X50. The insert
60 and the screw 70 are secured in the anchoring cavity B2. In some
embodiments that are not depicted, the insert 60 and the screw 70
are formed as a single component. In some embodiments, the axis X50
and the anchoring mechanism 50 are substantially perpendicular to
the abutment surface B1.
[0040] The insert 60 generally has a hollow-cylindrical shape with
a circular cross-section. The insert 60 includes a front opening 61
and a rear opening 62. The insert 60 facilitates centering the
implant 1 in the cavity B2 of the glenoid B. The insert 60 includes
a raised external surface 63, an external thread 64, a rear
frustoconical surface 65, an internal surface 66, an internal
shoulder 67, an internal thread 68 for coupling to the pin 40, and
an internal surface 69. In some embodiments, the anchoring axis X50
is defined by the insert 60 as opposed to the screw 70. In
particular, the anchoring axis X50 may be defined by the internal
thread 68 for coupling to the pin 40.
[0041] In some embodiments, the external surface 63 of the insert
60 includes raised portions that provide surface roughness to
facilitate mechanically coupling the insert 60 to the internal
walls of the anchoring cavity B2. The external thread 64, which may
be self-tapping, facilitates anchoring the insert 60 to the glenoid
B by screwing the insert into the cavity B2. In some embodiments
and depending on the depth to which the insert 60 is inserted in
the cavity B2, the rear surface 65 may abut the bottom of the
cavity B2.
[0042] In some embodiments, the internal surface 66 (see FIG. 1)
has an oval shape and is adapted to receive a tool, which may abut
the shoulder 67, to facilitate screwing the insert 60 into the
cavity B2. In some embodiments, the surface 66 may have other
shapes. For example, the surface 66 may have a polygonal shape, for
example, a hexagonal shape or a cylindrical shape. In such
embodiments, the tool for screwing the insert 60 into the cavity B2
may engage the thread 68. When the insert 60 is positioned in the
glenoid B, the thread 68 is able to receive the threaded base 46 of
the pin 40, specifically the thread 48. The internal surface 69
faces towards the front opening 61 and abuttingly receives the
screw 70.
[0043] The anchoring screw 70 includes a threaded body 71 and a
screw head 72. The screw head 72 includes a curved rear surface 73
and a front opening or hole 74, which may have a hexagonal shape.
The rear surface 73 abuts the internal surface 69 of the insert 60
when the threaded body 71 of the screw 70 is coupled to the glenoid
B. The front hole 74 is adapted to receive a tool (not shown), such
as a surgical screwdriver, to facilitate screwing the screw 70 into
the glenoid B. In some embodiments, the axis of the screw 70 may be
aligned with the anchoring axis X50 defined by the insert 60. In
some embodiments, when the screw 70 is screwed into the glenoid B,
the axis of that screw 70 may be inclined relative to the anchoring
axis X50.
[0044] The securing screw 80 includes a threaded body 81 and a
screw head 82. The screw head 82 includes a curved rear surface 83
and a front opening or hole 84, which may have a hexagonal shape.
The opening 84 is adapted to receive a tool (not shown), such as a
surgical screwdriver, to facilitate screwing the threaded body 81
of the screw 80 into the glenoid B. The rear surface 83 abuts the
edges of the opening 27 of the plate 20 when the threaded body 81
of the screw 80 is coupled to the glenoid B. In some embodiments,
the screw 80 is a "multidirectional" screw and the opening 27 is
shaped to receive the screw 80 along multiple axes relative to the
plate 20 and the glenoid B. As such, a surgeon may position the
screw 80 along any of various desirable axes relative to the plate
20 and the glenoid B. The screw 80, when received in the opening 27
of the plate 20, secures the plate 20 relative to the glenoid B. In
particular, the screw 80 rotatably secures the plate 20 about the
anchoring axis X50 of the anchoring mechanism 50 implanted in the
glenoid B.
[0045] In some embodiments that are not depicted, the
multidirectional securing screw 80 may be replaced or supplemented
by an expansion-type securing mechanism. For example, such a
securing mechanism may include a washer that radially expands in
the opening 27 while rotating a screw in the washer and into
bone.
[0046] In some embodiments, a method for implanting the implant 1
is as follows.
[0047] The surgeon first prepares the abutment surface B1 and the
anchoring cavity B2. The surgeon may prepare the surface B1 before
or after the cavity B2. As described above, the implant 1 may
include either a reversed articular body 10 or an anatomical
articular body. An anatomical articular body may be replaced by a
reversed articular body 10 during a later revision procedure.
[0048] The cavity B2 may be prepared as a hole that has a diameter
that is slightly smaller than the outer diameter of the insert 60,
specifically the thread 64 of the insert 60. The insert 60 is then
screwed in the cavity B2 via a tool (not shown) that includes a
distal end or tip adapted to couple to the internal surface 66 of
the insert 60. Another hole is then prepared in the glenoid B that
has a diameter that is slightly smaller than the diameter of the
threaded body 71 of the screw 70. In some embodiments, the hole is
formed by inserting a drill bit (not shown) through the openings 61
and 62 of the insert 60 and perpendicularly to the glenoid surface
B1. The drill bit may be guided by an additional tool (not shown)
that is positioned inside the insert 60. The anchoring screw 70 is
subsequently screwed into the hole and into the insert 60 via a
tool (not shown) that is inserted into the hole 74 of the screw 70.
Ultimately, the rear surface 73 of the screw 70 abuts the internal
surface 69 of the insert 60. In some embodiments and as shown in
the Figures, the thread 64 of the insert 60 is "right-handed" and
the insert 60 is screwed in a counter-clockwise direction to secure
the component to bone. In contrast, the thread 71 of the screw 70
is "left-handed" and the screw 70 is screwed in a clockwise
direction to secure the component to bone. As such, once the insert
60 and the screw 70 are positioned in the cavity B2, the anchoring
mechanism 50 is rotatably secured and inhibited from being
unscrewed. In some embodiments, the insert 60 is positioned to
provide a small space between the front opening 61 of the insert 60
and the mouth of the cavity B2. Such a construction permits milling
of a new surface B1 without milling the insert 60.
[0049] In a revision procedure for the glenoid B, for example, to
replace an anatomical articular body with a reversed articular body
10, the previously-formed cavity B2 and the previously-implanted
anchoring mechanism 50 may be used. However, the surface B1 may be
formed as a replacement for the previous surface of the glenoid B.
The surface B1 may be inclined relative to a plane perpendicular to
the previously-defined anchoring axis X50.
[0050] For either, a first procedure or a revision procedure, the
pin 40 is inserted into the insert 60 via the opening 61. A tool
(not shown) is then inserted into the hole 44 of the head 42 of the
pin 40 to screw the threaded base 46 of the pin 40 into the thread
68 of the insert 60. After this action, the rod 41 and the head 42
of the pin 40 extend out of the anchoring cavity B2 and past the
abutment surface B1. The plate 20 may then be positioned about the
pin 40 (that is, such that the groove 30 receives the rod 41), by
translating plate 20 across the abutment surface B1. In some
embodiments, the edge 34 of the groove 30 is dimensioned to slide
against the external surface of the rod 41. Due to the groove 30,
the plate 20 may simultaneously pivot and translate relative to the
pin 40 and the anchoring axis X50.
[0051] As such, the groove 30 and the pin 40 define an adjustment
mechanism for selectively adjusting the position of the plate 20,
before it is secured in position by the pin 40 and the screw 80, in
rotation about the anchoring axis X50 and in translation
transversely relative to the anchoring axis X50. Stated another
way, the groove 30 permits transverse translational adjustment of
the plate 20 relative to the axis X50 and rotational adjustment of
the plate 20 about the axis X50. For a given angular orientation of
the plate 20 and the axis A30 about the axis X50, translation of
the plate 20 is permitted, and each cavity 31-33 defines a
different transverse position of the plate 20 relative to the axis
X50. Stated another way, each cavity 31-33 defines a different
eccentric axis of the plate 20 for rotation of the plate 20
relative to the glenoid B.
[0052] The groove 30 and the pin 40 define an adjustment mechanism
for pivotably or tiltably adjusting the position of the plate 20
relative to the anchoring axis X50. This adjustment is facilitated
by a ball-type connection between the head 42 of the pin 40 and one
of any of the cavities 31, 32 or 33 of the groove 30. As such, if
the surface B1 is not exactly perpendicular to the axis X50, the
plate 20 may pivot relative to that axis X50 to abut the glenoid
surface B1.
[0053] After making one or more of the adjustments described above,
the plate 20 is secured relative to the anchoring mechanism 50, the
anchoring axis X50, and the glenoid B by the pin 40 and the screw
80. Specifically, the pin 40 is further screwed into the insert 60,
and the surface 43 of the pin 40 abuts the edge 34 of the groove 30
and is received in one of the cavities 31-33. This action secures
the plate 20 relative to the insert 60.
[0054] In some embodiments, the pin 40 is sufficient to secure the
plate 20 relative to the anchoring mechanism 50, the axis X50, and
the glenoid B. In some embodiments, both the pin 40 and the screw
80 are used to secure the plate 20 relative to the anchoring
mechanism 50, the axis X50, and the glenoid B. That is, in some
embodiments, the securing mechanism includes the pin 40 and, in
some embodiments, the securing mechanism includes the pin 40 and
the screw 80.
[0055] To couple the screw 80 to the implant 1 and the glenoid B,
another hole is then formed in the glenoid B that has a diameter
that is slightly smaller than the diameter of the threaded body 81
of the screw 80. The hole may be formed by passing a drill bit (not
shown) through the opening 27 of the plate 20 in a
non-perpendicular direction relative to the surface B1. The drill
bit may be guided by an additional tool or guide (not shown) that
is temporarily positioned in the opening 27. After forming the
hole, the securing screw 80 is screwed into the hole and into the
opening 27. The screw 80 may be driven using a tool (not shown)
that is received in the opening 84 of the screw 80.
[0056] The articular body 10 is then secured to the plate 20 by,
for example, impacting the body 10 onto the plate 20. Thus, in some
embodiments, accurate positioning of the plate 20 facilitates
accurate positioning of the articular surface 11 of the body 10
relative to the glenoid B. In some embodiments, the above method
reduces the risk of disassembly of the components of the implant 1.
After the implantation procedure, the body 10 is articulated with
the humerus to provide either the reversed shoulder prosthesis type
in the example of FIG. 3 or of the anatomical shoulder prosthesis
type when the articular body has an anatomical configuration.
[0057] In some embodiments, the implant 1 may be provided as part
of a surgical kit according the invention. In some embodiments, the
surgical kit includes at least one articular body and at least one
plate, such as the body 10 and the plate 20 illustrated in the
example of FIGS. 1 to 7. In some embodiments, the surgical kit
includes a plurality of articular bodies and/or a plurality of
plates, such as the plates 20, 120, 220, 320, 420 and 520 described
above and below.
[0058] FIGS. 8, 9 and 10 illustrate plates 120, 220 and 320
according to embodiments of the invention.
[0059] Some of the features of the plates 120, 220 and 320 are
similar to those of the plate 20 and have the same reference
numerals. For brevity, only different and additional features
relative to the plate 20 are described in detail below.
[0060] As shown in FIG. 8, the plate 120 includes two additional
through-openings 129 disposed on opposite sides of the groove 30.
The openings 129 are adapted for receiving additional securing
elements, such as screws (for example, the screw 80) or any other
suitable securing elements.
[0061] As shown in FIGS. 9 and 10, the plates 220 and 320 each
include a groove 230 and 330, respectively, that differs from the
groove 30. In these embodiments, each groove 230 and 330 includes a
single cavity 231 or 332, respectively. The cavities 231 and 332
are bounded by local edges 234 and 334, respectively. The grooves
230 and 330 form, together with the pin 40, adjustment mechanisms
for selectively adjusting the position of the plate 220 or 320
before it is secured by the securing mechanism (in terms of
rotation about the axis X50, translation relative to the axis X50,
and pivoting relative to the axis X50). The cavities 231 and 332
define different translational offsets relative to the outer
surface 21 for receiving the articular body 10.
[0062] In some embodiments, the plates 220 and 320 are provided in
a surgical kit according to the invention. As such, a surgeon may
select one of the plates 220 and 320 based on the desired
translation adjustment relative to the anchoring axis X50. The two
plates 220 and 320 are also selectively rotatably adjustable about
the axis X50 and selectively transversely translatably adjustable
relative to the axis X50. However, the plates 220 and 320 are
adjustable to different configurations due to the different
positioning of the cavities 231 and 332. In addition the plates 220
and 320 are also selectively pivotably adjustable, albeit to
different configurations due to the different positioning of the
cavities 231 and 332.
[0063] FIGS. 11 to 14 illustrate plates 420 and 520 according to
embodiments of the invention, and which may be provided in a
surgical kit according to embodiments of the invention.
[0064] Some features of the plates 420 and 520 are similar to those
of the plate 20, for example, the outer surface 21 that receives
the articular body 10. For brevity, only the differences relative
to the plate 20 are described in detail below.
[0065] The plates 420 and 520 lack a groove for adjustment.
Instead, the plates 420 and 520 include pins 440 and 540,
respectively, that facilitate positional adjustment. The pins 440
and 540 are integrally or monolithically formed in the plates 420
and 520, respectively, and are adapted to couple to the anchoring
mechanism 50 of the implant 1.
[0066] As shown in FIGS. 11 and 12, the plate 420 includes an edge
424 and a cavity 425 that are located on the front side of the
plate 420. The plate 420 also includes two through-openings 427 and
two through-openings 429 that extend from the front side to a rear
side of the plate 420. The openings 427 are generally similar to
the opening 27 and the openings 429 are generally similar to the
openings 129. In some embodiments, the openings 427 and 429 extend
through both the edge 424 and the cavity 425 and are disposed 90
degrees apart from each other about the pin 440.
[0067] In some embodiments, the pin 440 has a cylindrical
cross-sectional shape that is centered relative to the outer
surface 21 of the plate 420. The pin 440 includes an annular front
edge 442 that is located in the recess 425. The pin 440 extends
from the annular front edge 442, through the plate 420, and to a
rear annular edge 449. The pin 440 also includes a cylindrical bore
443 that extends through the plate 420 between the edges 442 and
449. The pin 440 has a greater height dimension at the rear side of
the plate 420 compared to the front side of the plate 420. At the
rear side of the plate 420, the pin 440 includes a thread 448 that
is adapted to couple to the anchoring mechanism 50 of the implant
1. The pin 440 defines an adjustment mechanism for rotatably
adjusting the plate 420 relative to the anchoring axis X50. When
the orientation of the plate 420 is adjusted relative to the axis
X50, the positions of the holes 427 and 429 are adjusted relative
to the axis X50.
[0068] As shown in FIGS. 13 and 14, the pin 540 is similar to the
pin 440 and includes the many of the same features. In FIGS. 13 and
14, such features have reference numerals increased by 100 compared
to those of FIGS. 11 and 12. For example, the pin 540 includes
edges 542 and 549, a bore 543, and a thread 548, which is adapted
to couple to the anchoring mechanism 50 of the implant 1. The plate
520 further includes an edge 524 and a cavity 525 that are located
at the front side and two through-openings that are identical to
the openings 429.
[0069] In some embodiments, the pin 540 is off-center relative to
the outer surface 21 of the plate 520. The pin 540 defines an
adjustment mechanism for rotatably adjusting the plate 520 relative
to the anchoring axis X50. When the orientation of the plate 520 is
adjusted relative to the axis X50, the positions of the openings
that receive securing screws are adjusted. In addition, the
position of the outer surface 21 of the plate 520 is also adjusted
due to the off-center position of the pin 540.
[0070] In some embodiments that are not depicted, the pins 420 or
520 may couple to the anchoring mechanism 50 via different
components, for example, with a rack type device, an expansion
element, a snap ring, or the like.
[0071] The positions of each of the plates 420 or 520 may be
rotatably adjusted before being secured by the securing mechanism.
When the plates 420 and 520 are provided in a surgical kit
according to embodiments of the invention, a surgeon may select one
of the plates 420 and 520 based on the desired adjustment of the
outer surface 21 relative to the axis X50. Thus, the two plates 420
and 520 are rotatably selectively adjustable about the axis X50. In
addition, the plates 420 and 520 are adjustable to a different set
of configurations due to the off-center position of the pin 540 of
the plate 520.
[0072] The implant 1 and/or the plates may take different forms
without departing from the scope of the invention. For example, the
articular body, the anchoring mechanism, the securing mechanism
and/or the adjustment mechanism may take different forms than the
exemplary embodiments that are shown and described.
[0073] In addition, the features of the different embodiments may
be, in their entirety or for some of them, combined with each
other.
[0074] Various modifications and additions can be made to the
exemplary embodiments discussed without departing from the scope of
the present invention. For example, while the embodiments described
above refer to particular features, the scope of this invention
also includes embodiments having different combinations of features
and embodiments that do not include all of the described features.
Accordingly, the scope of the present invention is intended to
embrace all such alternatives, modifications, and variations as
fall within the scope of the claims, together with all equivalents
thereof.
* * * * *